Searching for effective help for depressed youth
Meet... Yvonne Stikkelbroek
Yvonne Stikkelbroek, is an involved jack-of-all-trades with one foot in research and the other in practice. As an Assistant Professor at Utrecht University and a clinical psychologist at the TOP GGZ department Expertisecenter Depression Youth in East Brabant. She shares all her gained knowledge at conferences, lectures, and in the theatre. “I promised myself one thing when I went to obtain my PhD at age 51: if I take all this effort to get into research, I want to share it too. Both with the young clients and their parents.”
What are you primarily doing research into?
In a broad sense, I research how effective certain treatments are for depressed adolescents. One example is that I joined a research project by Jaël van Bentum, in which we look into how EMDR can be used for youngsters who are or were suicidal. Suicidal thoughts can sometimes be traumatising to youngsters, they can be afraid they’ll act on them. This treatment has been proven effective for adults, we are now looking into whether or not this is also true for adolescents.
How do you involve experts from practice in your research?
In the region I work in, East Brabant, we’re also working on prevention research. We enter the schools and train other professionals to screen youngsters for depression and suicidality. That has been set up very systematically with money from the municipalities in this region. We’ve been doing this for a number of years already. We started by visiting only the second-year classes, but now also the fourth-year classes in secondary school and intermediate vocational education. This method, the storm method, has made results and the approach has since been adopted in other regions.
The faster you recognise depression in youngsters, the easier it is to reduce the complaints. Once someone has had depression, there is a huge aftermath to it. If a youngster has a depression that lasts 5 months, an entire school year could be lost just like that. Maybe he or she is transferred to another class, away from friends, resulting in the youngster feeling lonely. That can then cause a gloomy mood. So depression can set off a cascade of problems.
Depression can set off a cascade of problems.
What else can practitioners do?
Practitioners need to keep better track of how well treatments work for their clients in practice by means of randomized controlled trials. In the past ten years, there have only been four of these trials for depression interventions among youngsters. For adults, there have been over 300. We can still gain from that. Personally, I'm working on setting up a single case experimental design. Youngsters can keep track of how they're doing with an app while they’re having treatment. We can use this data to see how successful the treatment is over a longer period as well. This way, we can track this group of adolescents longer and use the results to improve treatments.
According to the Health Behaviour in school-aged Children research project, youngsters' mental health is getting worse and worse. Do you see this in practice too?
Yes, I recognise that. The youngsters have more and longer-term symptoms, and it has a bigger effect on their daily functioning. I also notice that increasing pressure from school plays a bigger role.
What do we have to do as a society to make it easier for youngsters?
Reducing stress can make an important contribution. The most obvious is reducing the pressure to perform. For instance, by creating more opportunities for youngsters in secondary education who are not feeling that well for any period of time. Don't let them drop to lower levels of education immediately, with all the consequences that come with that.
What would you recommend to parents and youth professionals who are dealing with youngsters who have mental issues?
First of all, prevention is better than cure. Create a healthy environment in which youngsters can experiment and experience what their talents are and develop their self-worth. Try to avoid sources of stress and provide social support. Create perspective by looking into what can be achieved in the short run. Split up goals into smaller parts. Ensure that youngsters hear stories about youngsters who overcame mental issues. And how they did that. Especially don't think in terms of big changes. Sometimes, small changes can already result in big positive consequences.
Especially don't think in terms of big changes. Sometimes, small changes can already result in big positive consequences.
Suicide was mentioned in this article. Do you not like life anymore? It can help to talk. You can chat anonymously 24/7 via www.113.nl/english or call 113 or 0800-0113 (free of charge) within the Netherlands.
You think it's important to also pass your knowledge to a bigger audience. For instance, you contributed to the theatre show "What the f*ck is happiness?" What was your first impression of the show?
I was blown away when I saw the first tryout. Didn't think it was possible that the essence could be presented so well. In my work as a psychologist, I always make a lot of effort to express in language what depression is and how it feels towards youngsters, but also towards their parents. But that can be done much better with music and theatre.
Which aspect do you think was important to include in the show?
Making the experience visible from within in order for the environment and especially the parents to understand that it's not unwillingness or laziness. That’s essential in order to prevent the escalation of depressed feelings and to stand with someone in their depression. It's also important to show that small events, thoughts, and feelings interact with each other.
Which parts of the show are connected to the research you're doing?
In the Depression Expertise Center Youth, we do research within GGZ into possibilities to improve the effectiveness of treatments. About 56 % of youngsters experience a significant improvement but 44 % do not, with 6 % of them even doing worse during therapy. This show brings up that the main character but also the parents experience therapy as stressful and insufficiently helpful. That you have to look for the right approach.